Method and a system usable in creating a subsequent dental appliance
A current digital dental model is received that includes a representation of the set of physical teeth for the patient with the current dental appliance attached to the physical teeth or oral cavity. The current digital dental model is a direct digital scan of the set of physical teeth and the current dental appliance. The physical teeth are at a position in treatment when all or a part of the current dental appliance is desired to be removed from one or more of the set of physical teeth and it is desired to use a subsequent appliance. The current digital dental model is created based a new digital dental model that includes the representation of the set of physical teeth without including the current dental appliance.
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This application is a continuation application of U.S. application Ser. No. 13/605,949, filed Sep. 6, 2012, which is incorporated herein by reference in its entirety and to which application we claim priority under 35 USC § 120.
BACKGROUNDFrequently a patient will wear some type of dental appliance, such as a retainer, positioner, or splint, after their orthodontic braces have been removed in order to prevent the positions of the patient's teeth from deviating from the accomplished teeth arrangement. A set of braces is one example of what shall be referred to herein as a “current dental appliance.” A dental appliance that is worn after removal of the current dental appliance shall be referred to herein as a “subsequent dental appliance.” Retainers are an example of a subsequent dental appliance. Alternatively, patients in orthodontic braces may wish to discontinue wearing the bonded braces during treatment, and finish the remainder of their treatment with additional dental appliances such as a clear removable plastic aligner. In the event that the treatment consists of a combination of braces followed by removable aligners, a transition between the braces and aligners without having to manufacture a temporary holding retainer (to minimize tooth movement after the braces are removed) between the two phases of treatment is desired.
To manufacture the subsequent dental appliance, physical impressions may be taken with the current dental appliance still affixed to the patient's teeth in order to minimize the amount of undesirable tooth movement which may occur between the time after the removal of the current dental appliance and the time that the subsequent dental appliance is delivered. By leaving the current dental appliance on for the impressions, it is hoped that the subsequent dental appliance can be manufactured while the teeth are held in place with the current dental appliance and delivered immediately after the current dental appliances are removed. However, the impressions that are taken with the current dental appliance affixed on the patient can be difficult—not only for the clinician, but also for the patient—because of the undercuts present in the current dental appliance which lock in the impression material as it sets. This is not only uncomfortable and messy for the patient, but can also lead to impression distortion if, for example, excessive force is required to free the locked impression from the teeth when the current dental appliances are still present. As a result of any distortion in the impression, the subsequent dental appliances may not fit well on the patient's teeth when they are delivered. Even after the impression is taken, a technician will have to spend considerable effort manually cleaning up any model made from the impression and manually removing all parts of the current appliance and any distortion and other defects arising from taking the impression. These are just a few examples of why physical impressions are undesirable.
More often, the treating professional waits until the current dental appliance is removed before taking an impression. This eliminates some of the difficulties in taking the impression with the current appliance, but results in a need for a temporary retainer or no retainer for the period in which it takes to make a subsequent dental appliance. The later risks teeth movement before the subsequent dental appliance can be applied to the teeth. In either case, it also necessitates another appointment with the treating professional to fit and apply the subsequent appliance.
The accompanying drawings, which are incorporated in and form a part of this Description of Embodiments, illustrate various embodiments of the present invention and, together with the description, serve to explain the principles discussed below:
The drawings referred to in this Brief Description should not be understood as being drawn to scale unless specifically noted.
DESCRIPTION OF EMBODIMENTSAccording to one embodiment, a current digital dental model, such as a digital image, is made of the patient's physical teeth with one or more current dental appliances attached to the physical teeth normally just before the current dental appliance is to be removed and replaced with a subsequent dental appliance. If the subsequent appliance is an end-of-treatment retainer, the teeth are usually at or near a desired arrangement of the teeth. If the subsequent appliance is a middle-of-treatment appliance, the teeth are at a treatment arrangement that is between the initial arrangement and the desired arrangement.
Various types of direct or indirect scanning or imaging (such as an intraoral scan, CBCT, or various types of scan of physical models or impressions including laser and computed tomography) can be used for creating the current digital dental model. According to a preferred embodiment, the current digital dental model is a direct digital scan of the set of physical teeth with the current dental appliance attached to one or more of the physical teeth. Various embodiments may also be used with a current dental appliance that is attached to the patient's oral cavity, such as to the patient's bone beneath the gingiva.
Examples of a current dental appliance include any dental appliance suitable for attachment to one or more of the patient's teeth and a dental appliance suitable for attachment to the patient's bone beneath the gingival, among others. More specifically, the current dental appliance may consist of one or more items and may be all or a portion of a set of braces (which may include bonded brackets, buttons, cemented bands, or a combination thereof), a temporary anchorage device (TAD) that is attached to the patient's oral cavity, or a dental attachment that is suitable for use with a removable plastic positioning dental appliance (also referred to herein as an “aligner”), a dental appliance suitable for attachment to bone under the gingiva of the patient, a sleep apnea appliance, a splint, a bridge, an implant, an orthodontic band, a fixed lingual retainer, a set of lingual braces or any item that has been fixedly attached to any portion of the oral cavity, as examples. Examples of types of TADs are a mini screw, a mini plate, a ball type, a bracket type and a hook type. The current dental appliance may be positioned on either the facial/buccal surface, the lingual surface of the patient's physical teeth, the gingiva, or a combination thereof.
A new digital dental model of the aligned teeth (either fully or partially) can be created based on a model of the current teeth with the current dental appliance present or from a previous model of the unaligned teeth without the current dental appliance present. For example, the new digital dental model may be created by removing the current dental appliance from the current digital dental model or by moving digital teeth of an earlier time point (of the same patient) without the dental appliance present into the same positions as the teeth in the current digital dental model (with the dental appliance present), among other things as described herein. According to one embodiment, the creation of the new digital dental model is computer automated. The creation of the new digital dental model can be fully automated or substantially-automated.
A new digital dental model can be used to manufacture a subsequent dental appliance prior to removing the current dental appliance from the patient's physical teeth. Examples of a subsequent dental appliance are a retainer, an (active) aligner, an expander, a splint or bite guard, or a positioner. The retainer may be a Hawley, an Essix-type, a bonded wire, any vacuum-formed type stent, a spring-retainer, a clear splint, or a combination thereof. At least one example of a splint is an orthognathic surgery splint, among others.
According to one embodiment, the current digital dental model and the new digital dental model includes a portion of the patient's gingiva. For example, the current digital dental model and the new digital dental model may include at least the portion of the patient's gingiva that would be covered over by or adjacent to a subsequent dental appliance.
According to one embodiment, the current digital dental model and a new digital dental model may include digital teeth that represent all of a patient's physical teeth clinically present (i.e. unerupted and/or impacted teeth not included) whether natural or prosthetic (e.g., dental crown or bridge pontic). For the sake of simplicity however, many of the figures depict a subset of the patient's physical teeth.
Example 110 depicts the patient's set of physical teeth 100 with a set of orthodontic braces 112 attached. The set of braces 112 may include one or more brackets, archwires, etc. Example 120 depicts the patient's set of physical teeth 100 with dental attachments 122 that are suitable for use with a removable plastic positioning dental appliance, such as an aligner. Example 130 depicts an orthodontic band attached to the patient's set of physical teeth 100. Example 140 depicts spaces 142, 146 on the side of the tooth and a space 144 at the back of the tooth after the removal of the orthodontic band 132 has been removed. Example 150 depicts a fixed lingual retainer 152. Example 160 depicts lingual braces.
The dental brackets and dental attachments as depicted in
The patient's set of physical teeth 100 are at or close to a desired teeth arrangement, according to one embodiment. A desired teeth arrangement, according to one embodiment, is the final teeth arrangement that is accomplished as a result of orthodontic treatment. According to one embodiment, the patient's physical teeth 100 may be at the desired teeth arrangement as a result of an orthodontic treatment. According to another embodiment, the patient's physical teeth 100 are close to, but not exactly at the desired teeth arrangement. For example, due to the current dental appliance 112, a feature such as a cemented orthodontic band 132 (
Although many embodiments are described in the context of a set of braces 112, the current dental appliance may be any type of dental appliance that can be attached to one or more of the patient's physical teeth 100 or to the patient's tissues within the oral cavity. The current dental appliance may be any type of dental appliance that is suitable for use with a removable plastic positioning dental appliance.
According to one embodiment, a digital scan of the patient's physical teeth 100 is taken without any dental appliance being on the patient's physical teeth 100. The digital scan can be processed to create segmented digital teeth 200 of the patient. Each 200a-200d of the segmented digital teeth 200 represents a different one 100a-100d (
Each of the segmented digital teeth 200a-200d can be superimposed on the corresponding digital teeth 210a-210d associated with the current digital dental model 210. The surfaces shared in common (i.e. not covered by the dental appliance) can be used as references and the basis for the superimposition. A new location for the segmented digital teeth 200a-200d can then be assigned to each individual tooth, based on the position of the equivalent tooth in the new digital dental model 220 (the new digital dental model 220 can be segmented or unsegmented or partially segmented). The non-superimposed portion includes any portion of the current digital dental model 210 that is not part of the original digital dental model as represented by the segmented digital teeth 200. For example, the non-superimposed portion can include the current dental appliance 112 and any cement that is used for attaching the current dental appliance 112 to the patient's physical teeth 100 (
A representation of all 300 or a portion 300a, 300b of the current dental appliance 112 (
The representation of the current dental appliance 300 can be superimposed on the current digital dental model 210 (
According to one embodiment, the new digital dental model 320 may include representations of excess cement or offsets to the surfaces of the physical teeth due to the cement, or a combination thereof. Therefore, a subsequent dental appliance that is created based on the new digital dental model 320 will fit the patient's physical teeth 100 (
As depicted in
Various embodiments are well-suited for approximating the contour 450 of a portion 440 a digital tooth portion 440 based on other portions, as discussed herein, of a dental appliance besides a bracket base, as discussed herein. For example, if a portion of a digital tooth is beneath a bonded lingual wire, various embodiments are well-suited for using a contour underneath the bonded lingual wire to estimate the contour of a portion of digital tooth that would be beneath that wire.
Referring to
A similar digital tooth 500a-500d may be resized based on the size of a digital tooth 210a-210d (
A similar digital tooth 500a-500d, according to one embodiment, has its own three dimensional (3D) coordinates, as discussed herein, so that a similar digital tooth 500a-500d can be positioned, for example, based on the position of a corresponding digital tooth 210a-210d (
Each of the similar digital teeth 500a-500d can be superimposed on corresponding digital teeth 210a-210d (
According to one embodiment, the physical teeth 100 (
Therefore, according to one embodiment, to create a current digital dental model 210 (
According to one embodiment, a new digital dental model 220-620 (
According to one embodiment, one or more changes in the patient's gingiva is simulated, as will be described in more detail in the context of
Various embodiments are also well-suited for changes in the gingiva that result from a TAD or other types of devices that cause changes to the gingiva. For example, a portion of a TAD will typically be embedded in the gingiva into the bone beneath, which can cause a portion of the gingiva to swell. Various embodiments, such as a simulation, not requiring a simulation, and using the patient's original gingiva contour (depicted at time t0 in
As discussed herein, for the sake of simplicity, many embodiments were described in the context of a current digital dental model 210 that is a representation that included a set of braces. However, as discussed herein, embodiments are well suited for removing a current dental appliance 122 (
According to one embodiment, the creation of a new digital dental model 220-620 (
According to various embodiments, a current digital dental model 210 (
According to one embodiment, a new digital dental model 220-620 (
The system 900 includes a current-digital-dental-model-receiving-component 910 and a new-digital-dental-model-creation-component 920. The new-digital-dental-model can either be segmented, partially segmented or unsegmented. The current-digital-dental-model-receiving-component 910 is suitable for receiving a current digital dental model 210 (
The new-digital-dental-model-creation-component 920 is suitable for computer automated creation of a new digital dental model 220-620 (
The new-digital-dental-model-creation-component 920 may be further suitable for superimposing a segmented digital tooth 200a-200d (
According to one embodiment, the new digital dental model 220-620 (
According to one embodiment, the new digital dental model 220-620 (
At 1010, the method begins. At 1020, a current digital dental model 210 (
The current dental appliance may be any dental appliance that can be attached to one or more of the patient's physical teeth 100 (
At 1030, a new digital dental model 220-620 (
Referring to
Referring to
Referring to
Referring to
Referring to
The following is an example of combining various embodiments to create a new digital dental model. The current dental appliance 300 can be removed from the representation 210, as illustrated
The following is another example of combining various embodiments to create a new digital dental model. A segmented digital tooth 200a-200d of the patient can be superimposed on a first digital tooth 210a associated with the current digital dental model 210 as illustrated in
Various embodiments for creating a new digital dental model 220-620 (
According to one embodiment, the physical teeth 100 (
At 1040, digital data suitable for use in manufacturing the subsequent dental appliance is provided based on electronic data included in the new digital dental model 220-620 (
At 1050, the method ends. The receiving at 1020 and the creating at 1030 are performed by one or more computer processors, according to one embodiment. Although specific operations are disclosed in flowchart 1000, such operations are exemplary. That is, embodiments of the present invention are well-suited to performing various other operations or variations of the operations recited in flowchart 1000. It is appreciated that the operations in flowchart 1000 may be performed in an order different than presented, and that not all of the operations in flowchart 1000 may be performed.
According to one embodiment, a subsequent dental appliance can be manufactured based on the provided digital data, such as electronic data included in the new digital dental model, prior to removal of all or part of the current dental appliance from the set of physical teeth. For example, the electronic data included in the new digital dental model can be used to fabricate a mold using a rapid-prototyping machine or milling machine and forming the subsequent dental appliance over the mold.
As a frame of reference describing how a digital tooth 1600 may be moved, an arbitrary centerline (CL) may be drawn through the digital tooth 1600. With reference to this centerline (CL), a tooth 1600 may be moved in orthogonal directions represented by axes 1604, 1606, and 1608 (where 1604 is the centerline). The centerline may be rotated about the axis 1608 (root angulation) and the axis 1604 (torque) as indicated by arrows 1610 and 1612, respectively. Additionally, the tooth 1600 may be rotated about the centerline, as represented by an arrow 1612. Thus, all possible free-form motions of the tooth 1600 can be performed.
One technique is very similar to the neighborhood filtered cusp detection technique described above, in that voxel neighborhoods 1788, 1790 are defined on one of the 2D-planes to focus the computer's search for cusps on adjacent 2D plane. Upon detecting a pair of cusps 1784, 1786 on one 2D plane, the computer defines one or more neighborhoods 1788, 1790 to include predetermined number of voxels surrounding the pair. The computer projects the neighborhoods onto an adjacent 2D plane by identifying the voxels on the adjacent plane that correspond to the voxel in the neighborhoods 1788, 1790 on the original plane. The computer then identifies the pair of black voxels that lie closest together in the two neighborhoods on the adjacent plane, labeling these voxels as lying in the cusp. The computer repeats this process for all remaining planes.
Many of these automated segmentation techniques are even more useful and efficient when used in conjunction with human-assisted techniques. For example, techniques that rely on the identification of the interproximal or gingival margins function more quickly and effectively when a human user first highlights the interproximal or gingival cusps in a graphical representation of the dentition model. One technique for receiving this type of information from the user is by displaying a 2D or 3D representation and allowing the user to highlight individual voxels in the display. Another technique allows the user to scroll through a series of 2D cross-sectional slices, identifying those voxels that represent key features such as interproximal or gingival cusps. Some of these techniques rely on user interface tools such as cursors and bounding-box markers.
In many instances, the computer creates proposals for segmenting the dentition model and then allows the user to select the best alternative. For example, one version of the arch curve fitting technique requires the computer to create a candidate catenary or spline curve, which the user allowed to modify by manipulating the mathematical control parameters. One technique involves displaying several surfaces that are candidates cutting surfaces and allowing the user to select the appropriate surfaces.
According to one embodiment, a tangible computer readable storage medium having computer-executable instructions stored thereon for causing a computer system to perform a method of creating a subsequent dental appliance prior to removal of a current dental appliance 112, 122, 132, 152, 162, 820 (
According to one embodiment, the creating 1030 (
A new digital dental model 220-620 (
Example embodiments of the subject matter are thus described. Although the subject matter has been described in a language specific to structural features and/or methodological acts, it is to be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or acts described above. Rather, the specific features and acts described above are disclosed as example forms of implementing the claims.
Various embodiments have been described in various combinations and illustrations. However, any two or more embodiments or features may be combined. Further, any embodiment or feature may be used separately from any other embodiment or feature. Phrases, such as “an embodiment,” “one embodiment,” among others, used herein, are not necessarily referring to the same embodiment. Features, structures, or characteristics of any embodiment may be combined in any suitable manner with one or more other features, structures, or characteristics.
Claims
1. A method usable in creating a subsequent dental appliance comprising:
- receiving a current digital dental model that includes a first representation of the set of physical teeth for the patient with a current dental appliance attached to the physical teeth or oral cavity;
- creating, based on the current digital dental model, a new digital dental model that includes the first representation of the set of physical teeth without the current dental appliance by: superimposing a second representation of all or a portion of the current dental appliance on the current dental appliance associated with the first representation; determining a superimposed portion of the first representation based on the superimposing; and creating the new digital dental model by removing the superimposed portion of the first representation;
- adjusting the new digital dental model by moving one or more teeth to a desired teeth arrangement; and
- providing digital data suitable for use in manufacturing a subsequent dental appliance based on electronic data included in the new digital dental model.
2. The method as recited by claim 1, wherein the superimposing of the second representation of all or the portion of the current dental appliance further comprises:
- superimposing the second representation of the portion selected from a group consisting of a bracket, a wire, button, a cleat, a tube, a hook, a band, a ligature, an aligner attachment and an O-ring.
3. The method as recited by claim 1, wherein the method further comprises:
- receiving an image of the current dental appliance when not applied to one or more of the physical teeth of the patient; and
- using the image as the second representation.
4. The method as recited by claim 1, wherein the method further comprises:
- receiving an image of a dental appliance that is the same or similar type of dental appliance as the current dental appliance; and
- using the image as the second representation.
5. The method as recited by claim 4, wherein the method further comprises:
- receiving the image from a library of dental appliances.
6. The method of claim 1, wherein the subsequent dental appliance is an end-of-treatment retainer.
7. The method of claim 1, wherein the subsequent dental appliance is a middle-of-treatment appliance.
8. The method of claim 1, wherein the current digital dental model is created using direct or indirect scanning or imaging.
9. The method of claim 1, wherein the new digital dental model includes a portion of the patient's gingiva that is in proximity of the subsequent dental appliance, would be covered by the subsequent dental appliance, or a combination thereof.
10. The method of claim 1, further comprising simulating one or more changes in the patient's gingiva.
11. A method for creating a subsequent dental appliance prior to removal of a current dental appliance from a set of physical teeth for a patient, the method comprising:
- receiving a current digital dental model that includes a representation of the set of physical teeth for the patient with the current dental appliance attached to the physical teeth or oral cavity;
- creating, based on the current digital dental model, a new digital dental model that includes the representation of the set of physical teeth without including the current dental appliance by: superimposing, by the computer processors, each of segmented digital teeth on corresponding digital teeth associated with the current digital dental model; determining, by the computer processors, a non-superimposed portion of the current digital dental model based on the superimposing; and creating, by the computer processors, the new digital dental model by removing the non-superimposed portion of the current digital dental model or based on a superimposed portion without the non-superimposed portion;
- adjusting the new digital dental model by moving one or more teeth to a desired teeth arrangement; and
- providing digital data suitable for use in manufacturing a subsequent dental appliance based on electronic data included in the new digital dental model.
12. The method of claim 11, wherein the current digital dental model comprises a bracket, a wire, a button, a cleat, a tube, a hook, a band, a ligature, an aligner attachment, or an O-ring.
13. The method of claim 11, wherein the method further comprises:
- receiving an image of the current dental appliance when not applied to one or more of the physical teeth of the patient; and
- associating the image with the current digital dental model.
14. The method of claim 11, wherein the method further comprises:
- receiving an image of a dental appliance that is the same or similar type of dental appliance as the current dental appliance; and
- associating the image with the current digital dental model.
15. The method of claim 14, wherein the method further comprises receiving the image from a library of dental appliances.
16. The method of claim 11, wherein the subsequent dental appliance is an end-of-treatment retainer.
17. The method of claim 11, wherein the subsequent dental appliance is a middle-of-treatment appliance.
18. The method of claim 11, wherein the current digital dental model is created using direct or indirect scanning or imaging.
19. The method of claim 11, wherein the new digital dental model includes a portion of the patient's gingiva that is in proximity of the subsequent dental appliance, would be covered by the subsequent dental appliance, or a combination thereof.
20. The method of claim 11, further comprising simulating one or more changes in the patient's gingiva.
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Type: Grant
Filed: Nov 26, 2018
Date of Patent: Sep 6, 2022
Patent Publication Number: 20190090982
Assignee: Align Technology, Inc. (San Jose, CA)
Inventor: Eric Kuo (San Jose, CA)
Primary Examiner: Kibrom K Gebresilassie
Application Number: 16/200,445
International Classification: A61C 7/00 (20060101); A61C 9/00 (20060101); A61C 7/14 (20060101); A61C 7/20 (20060101);